Job Summary

We are looking for a detail-oriented and organized Provider Enrollment Specialist to manage the timely and accurate enrollment of healthcare providers with government and commercial insurance payers. The specialist will be responsible for preparing and submitting enrollment applications, tracking application status, maintaining provider information, and coordinating with healthcare organizations and payer representatives to resolve enrollment-related issues.

The ideal candidate will have experience in provider enrollment, credentialing, medical billing, or a related healthcare administrative function, along with robust knowledge of payer enrollment processes and provider databases.

Key Responsibilities
- Prepare, submit, and track provider enrollment and credentialing applications with Medicare, Medicaid, and commercial insurance payers.
- Assist with the creation, maintenance, and regular updates of CAQH profiles.
- Monitor enrollment applications and proactively follow up with payers to ensure timely processing.
- Communicate with insurance companies,



healthcare providers, hospital/system representatives, and internal teams to resolve enrollment issues.
- Review applications and supporting documentation for completeness and accuracy before submission.
- Maintain accurate provider enrollment records and documentation in accordance with payer and organizational requirements.
- Monitor provider enrollment status and identify missing information, discrepancies, or potential delays.
- Maintain confidentiality and professionalism while handling provider and organizational information.
- Track and maintain daily work production, productivity, and application status reports.
- Ensure enrollment activities are completed within established timelines and quality standards.
- Navigate payer portals and web-based applications to submit, update, and monitor enrollment requests.
- Support other provider enrollment and credentialing activities as assigned.

Require

📌 Walk-in || Hiring For Provider Enrollment Specialist (Hyderabad)
🏢 Sutherland
📍 Hyderabad